Medical Treatments

2:11 pm

Fri July 11, 2014

Health Officials Push HIV Prevention Pills

The World Health Organization has announced a sweeping new guideline, recommending that all men who have sex with mean take antiretroviral drugs to prevent HIV infection. The Centers for Disease Control and Prevention issued a similar recommendation in May. For more on these announcements, Melissa Block speaks with reporter Richard Knox.

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Transcript

MELISSA BLOCK, HOST:

This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block. Today a sweeping recommendation aimed at preventing HIV. The World Health Organization says men who have sex with men should take a daily pill, that along with condom use can virtually eliminate the risk of getting infected with the AIDS virus. The prevention pill has been approved in many countries, including the U.S., for a couple of years but so far it has not been widely used. The WHO hopes to change that. Reporter Richard Knox has been following the story and he joins me now. And first Richard let's talk about the prevention pill its self. How does it work?

RICHARD KNOX, BYLINE: It is called pre-exposure prophylaxis or PrEP for sure. It's a pill that's used - two drugs that are now used for treatment of HIV but can also prevent it. There's some big studies that have shown daily use can lower the risk of infection among gay and bisexual men by 92 percent. It doesn't replace the need for a condom, I should say. They need to be used together. But they can have a really big impact on HIV prevention and that's still a big problem. In the United States gay and bi-men account for more than 60 percent of new infections of HIV. And in some countries 10 percent of the population of men who have sex with men get infected every year. That's way higher than the general population.

BLOCK: Now as we mentioned this pill has been approved for a couple of years but it hasn't caught on. Why not? What's the problem there?

KNOX: It takes a while for any new prevention method to get adopted by doctors and for patients to know about it and want it. Only this May did the CDC recommend the use for gay and bi-men who were at high risk. Cost has been a big factor, in the United States the drug alone costs over $10,000 and then people have to be tested and monitored. But more and more insurers are covering it, and so I'm told that more patients are beginning to ask for it in this country. In developing countries the price of the pill has come way down.

BLOCK: How far down has that price come?

KNOX: To below $100 a year in many countries. That's because Gilead Sciences, which is the U.S. company that makes the pill is licensing generic companies in various countries to make it. And that brings it down to around 25 cents a day in places and that's as one WHO official pointed out to me, about the cost of a cup of tea in India. And that's really what's really behind the WHO being able to make this bold recommendation.

BLOCK: And what would it take for the prevention pill, with daily use, to really catch on.

KNOX: Well it's going to take a big push by governments around the world, which is what WHO's trying to get going. And it will also will take consumer demand. The WHO has more than 28 studies I'm told from different countries, showing that men who have sex with men really do want access to this pill, if they know about it. And they're planning to push it as part of a big shift in their prevention strategy, to focus on men who have sex with men, sex workers, prison inmates, injection drug users where the epidemic is really going. One leading expert in HIV prevention, Dr. Ken Mayer, says this is really the cutting edge. More new technologies for preventing HIV infection are coming along. And he says it's basically where oral contraception was about 50 years ago.